Mental Health Nursing in Australia: Cultural Diversity Impact

This essay critically analyzes the evolution of mental health nursing practices in Australia over the past two decades, with a specific focus on the impact of these changes on culturally diverse populations, including refugees and immigrants. The paper examines the clinical and psychosocial outcomes of mental health care delivery, highlighting the challenges and advancements in addressing the needs of these groups. It discusses the impact of cultural and language barriers, the introduction of medical interpreters, and the implementation of policies promoting social inclusion and transcultural nursing. The essay reviews the changes in mental health nursing practice, including the introduction of specialized groups and programs. The essay also references various studies and surveys to assess the changes in the prevalence of mental health disorders, the utilization of mental health services, and the improvement in patient outcomes. The conclusion summarizes the improvements in clinical and psychological outcomes resulting from the changes in mental health nursing practice, emphasizing the role of policy-making, cultural competency, and accessibility of services.

Nursing in Mental health
Name of the Student
Name of the University
Author Note

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Over the past two decades the mental health nursing practice in Australia have
significantly changed in terms of delivering care for young people and to people from different
cultures. The essay critically analyses the impact of the change in the care delivery process in the
mental health nursing on the clinical and the psychosocial outcomes. The focus of the paper is on
the mental health care delivery for people of different culture. The essay discusses the
psychosocial outcomes of mental health nursing in this target group.
Cultural diversity in Australia continues to increase growing population of refugees and
migrants. Refugees and immigrants arrive in Australia for diverse purposes, which make the
country a multi-cultural society. Most of them belong to Vietnam, China, India, New Zealand,
UK and Italy (Kidd et al., 2015). The process of resettlement puts mental health of these people
at risk. In Australia, the mental health disorders are highly prevalent among the culturally
diverse community. This culturally diverse population was the core consideration of mental
health policy making and the funding for the implementation of the policies. However, two
decades ago the these policy statements were not translated into implementation objectives.
There was lack of sufficient funding to support implementation. In addition, there was no
reporting of the progress against policy developed for refugee and immigrant communities
(Holland, 2017).
According to De Crespigny et al. (2015), dealing with the culturally diverse people
involves challenges due to language and cultural barriers for mental health nurses. Only few
small-scale studies reported high prevalence of the mental health disorders in Indigenous,
refugee, and immigrant communities. The findings were incomplete and contradictory. These
communities were reported to underutilise the specialist private mental health services, primary
care, psychiatric disability and rehabilitation support services.

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These scenarios have changed a lot with the introduction of policy making an inclusion of
culturally diverse people in decision-making, introduction of medical interpreters who offer
translating and interpreting services. In recent decade, Australia has made impressive start to
measure routine outcome in mental health nursing (McMurray & Clendon, 2015). Outcome
measures mainly include cognition, emotion, functioning measures of quality of life. The clinical
outcome mainly includes improvement in systematology and functioning of individuals instead
of personal recovery. The social outcome indicators were identified as participation of young,
older adults and working people from different cultures in mental health services and reduction
in stigmatisation attitude (Thornicroft & Slade, 2014).
However, currently the immigrants and refugees adolescents who are mental health
patients can access “Refugee health network of Australia” at two fold higher rate that in three
decades ago. These networks provide professionals who are specialised in refugee health. Other
organisations such as Mental Health in Multicultural Australia also offer translated sources,
which is mainly accessed by the non-English speaking communities. It includes Pakistani,
Mandarin, Cantonese and Arabic people (Minas et al., 2013). Several recent policies include
clearer focus on utilisation of the mental health resources by the CALD communities in
Australia. The mental health nursing practice has changed with the introduction of “Australian
College of Mental Health Nurses Aboriginal and Torres Strait Islander Special Interest Group”
(Morrison-Valfre, 2016). These programs aim to develop culturally competent mental health care
services by introducing Transcultural nursing. These programs have increased the hospitals
admission rate for psychosis, dementia, Schizophrenia among the ethnic and minority’s
community in Australia (mainly people from New Zealand, Australian Aboriginals and UK)
(Stuart, 2014).

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As per the reports of 2010 based on the survey of mental health disorder among the
immigrant and communities of culturally and linguistically diverse population, the prevalence of
anxiety disorders, substance abuse disorders, psychosis, posttraumatic stress disorder have
decreased by three times in the last two decades. The self-harm and the suicide behaviours
profoundly seen in Aboriginal adolescents and asylum seekers have reduced but not remarkably
in last two decades (Cleary et al., 2014). These reports showed greater participation of women
than men, in services for anxiety disorders in Chinese community. The GP consultations among
the refugees from Bangladesh, Vietnam, Pakistan, India and other refugee communities have
improved in last two decades. There is an increase in mental health literacy among the Chinese
community in last two decades living in Melbourne. A greater participation in psychotherapy
sessions was found among the overseas students from New Zealand and India for general anxiety
disorder and post-traumatic stress disorder (Mace et al., 2014).
According to the latest survey of mental health and well-being, there is increase in people
from different culture reporting about fulfilment of the mental health care needs. Depressive
symptoms were found to decrease in the Tamil asylum seekers. Burmese refugees showed
greater access to treatment for post-traumatic stress treatment. In the last two decades, the
Vietnamese refugees showed low presentations to mental heaths clinics. There is a negligible
improvement in the self-harm behaviour and suicide risk rates among the young and elderly
adults of Northern, western and Eastern European communities. A low suicide rate was
found in immigrants from Sothern Europe, South-East Asia, and the Middle East in
Australia (Lam et al., 2010).

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A greater percentage of Aboriginal and Torres Strait Islanders people particularly
adolescents still represented in drug and alcohol abuse, psychosis, schizophrenia, post-traumatic
stress disorder, obsessive-compulsive disorder and general anxiety disorder. The findings that are
two decades old report lower utilisation of the mental health services (Truong et al., 2014). The
policy of social inclusion allowed more mental health patients to participate in education and
training programs, voice their feelings to influence decisions, deal with crisis and connect with
family and friends (De Crespigny et al., 2015). However, these data does not indicate too much
about improvement in the clinical and psychosocial outcomes of people from diverse cultural
background.
Based on the through literature search, it can be concluded that the there is an
improvement in the clinical and psychological outcomes with changes in mental health nursing
practice for people from different cultures. These outcomes were evident due to policy making
with criteria of social inclusion, Transcultural nursing and accessibility of services such as
medical interpreters and mental health services for refugees and advocacy organisations, Refugee
health network of Australia. Thus, the improvement in the psychosocial outcomes such as
optimism, social inclusion, development of positive identity, meaningfulness in life among the
culturally diverse mental health people is still debatable.

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